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A pilot randomized controlled trial of assertive treatment including family involvement and home delivery of medication for young adults with opioid use disorder.

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Title: A pilot randomized controlled trial of assertive treatment including family involvement and home delivery of medication for young adults with opioid use disorder.
Authors: Fishman, Marc (AUTHOR), Wenzel, Kevin (AUTHOR), Vo, Hoa (AUTHOR), Wildberger, Jared (AUTHOR), Burgower, Rachael (AUTHOR)
Source: Addiction. Mar2021, Vol. 116 Issue 3, p548-557. 10p. 3 Charts, 2 Graphs.
Subjects: Analgesics, Confidence intervals, Controlled release preparations, Convalescence, Drugs, Families, Medical care, Naltrexone, Narcotics, Patient compliance, Statistical sampling, Substance abuse, Survival analysis (Biometry), Disease relapse, Pilot projects, Home environment, Randomized controlled trials, Proportional hazards models, Descriptive statistics, Adolescence
Geographic Terms: Maryland
Abstract: Background and Aims: Although medications for opioid use disorder (OUD), including extended‐release naltrexone (XR‐NTX), have demonstrated effectiveness, adherence is often low. We tested the preliminary efficacy of youth opioid recovery support (YORS), a multi‐component intervention designed to improve engagement and medication adherence for young adults with OUD. Design Single‐site randomized controlled trial with 24‐week follow‐up. Setting: Community substance use disorder treatment program in Baltimore, MD, USA. Participants: Young adults aged 18–26 years enrolled in inpatient/residential OUD treatment intending to pursue outpatient OUD treatment with XR‐NTX. Twenty‐one participants were randomized to YORS and 20 to treatment as usual (TAU). The analyzed sample was 65.8% male. Intervention and comparator: Components of YORS include: (1) home delivery of XR‐NTX; (2) family engagement; (3) assertive outreach; and (4) contingency management for receipt of XR‐NTX doses. The comparator was TAU, which consisted of a standard referral to outpatient care following an inpatient stay. Measurements Primary outcomes were number of XR‐NTX doses received over 24 weeks and relapse to opioid use (defined as ≥ 10 days of use within 28 days) at 24 weeks. Findings Participants in the YORS condition received more XR‐NTX doses [mean = 4.28; standard deviation (SD) = 2.3] compared with those in TAU (mean = 0.70; SD = 1.2), P < 0.01. Participants in the YORS group compared with TAU had lower rates of relapse (61 versus 95%; P < 0.01). Survival analyses revealed group differences on time to relapse with participants in TAU being more likely to relapse sooner compared with participants in the YORS condition [hazard ratio (HR) = 2.72, 95% confidence interval (CI) = 1.26–5.88, P < 0.01]. Conclusions: The youth opioid recovery support intervention for extended‐release naltrexone adherence and opioid relapse prevention among young adults with opioid use disorder appeared to improve treatment and relapse outcomes compared with standard treatment. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: A pilot randomized controlled trial of assertive treatment including family involvement and home delivery of medication for young adults with opioid use disorder.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Addiction%22&quot;&gt;Addiction&lt;/searchLink&gt;. Mar2021, Vol. 116 Issue 3, p548-557. 10p. 3 Charts, 2 Graphs.
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  Data: Background and Aims: Although medications for opioid use disorder (OUD), including extended‐release naltrexone (XR‐NTX), have demonstrated effectiveness, adherence is often low. We tested the preliminary efficacy of youth opioid recovery support (YORS), a multi‐component intervention designed to improve engagement and medication adherence for young adults with OUD. Design Single‐site randomized controlled trial with 24‐week follow‐up. Setting: Community substance use disorder treatment program in Baltimore, MD, USA. Participants: Young adults aged 18–26 years enrolled in inpatient/residential OUD treatment intending to pursue outpatient OUD treatment with XR‐NTX. Twenty‐one participants were randomized to YORS and 20 to treatment as usual (TAU). The analyzed sample was 65.8% male. Intervention and comparator: Components of YORS include: (1) home delivery of XR‐NTX; (2) family engagement; (3) assertive outreach; and (4) contingency management for receipt of XR‐NTX doses. The comparator was TAU, which consisted of a standard referral to outpatient care following an inpatient stay. Measurements Primary outcomes were number of XR‐NTX doses received over 24 weeks and relapse to opioid use (defined as ≥ 10 days of use within 28 days) at 24 weeks. Findings Participants in the YORS condition received more XR‐NTX doses [mean = 4.28; standard deviation (SD) = 2.3] compared with those in TAU (mean = 0.70; SD = 1.2), P &lt; 0.01. Participants in the YORS group compared with TAU had lower rates of relapse (61 versus 95%; P &lt; 0.01). Survival analyses revealed group differences on time to relapse with participants in TAU being more likely to relapse sooner compared with participants in the YORS condition [hazard ratio (HR) = 2.72, 95% confidence interval (CI) = 1.26–5.88, P &lt; 0.01]. Conclusions: The youth opioid recovery support intervention for extended‐release naltrexone adherence and opioid relapse prevention among young adults with opioid use disorder appeared to improve treatment and relapse outcomes compared with standard treatment. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=148631458
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    Identifiers:
      – Type: doi
        Value: 10.1111/add.15181
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 10
        StartPage: 548
    Subjects:
      – SubjectFull: Analgesics
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Controlled release preparations
        Type: general
      – SubjectFull: Convalescence
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      – SubjectFull: Drugs
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      – SubjectFull: Families
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      – SubjectFull: Narcotics
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      – SubjectFull: Survival analysis (Biometry)
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      – SubjectFull: Disease relapse
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              Text: Mar2021
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